A newly licensed nurse reports being publicly criticized by a more experienced nurse during a shift, which makes the new nurse feel devalued and anxious. Based on evidence-based strategies for addressing incivility, what is the best immediate action the nurse educator should recommend to the newly licensed nurse?

Rationale:

A. Assign a yellow tag to clients unable to walk but with stable vitals and no respiratory distress, indicating delayed care is correct. Yellow tags indicate “delayed” or non-urgent care, appropriate for patients who need attention but can safely wait while more critical patients are treated first.

B. Allocate immediate resources to clients with severe injuries and very low likelihood of survival to attempt life-saving measures is incorrect. SALT triage prioritizes resources to maximize survivable outcomes, meaning patients unlikely to survive even with intervention are assigned a black tag (expectant) rather than receiving immediate resources.

C. Tag as green clients who are alert, oriented, ambulatory, and have minor injuries such as abrasions or sprains is correct. Green tags indicate “minor” or “walking wounded” patients who require minimal intervention, allowing resources to focus on higher-acuity patients.

D. Assign a red tag to a client who is breathing rapidly, has a weak pulse, and responds only to painful stimuli is correct. Red tags indicate “immediate” priority for life-threatening injuries where intervention can save the patient.

E. Perform detailed diagnostic assessments and treatments at the triage site for all clients before tagging is incorrect. SALT triage emphasizes rapid assessment to categorize patients, not detailed diagnostics, which would delay care for critically injured patients.

F. Assign a red tag to an ambulatory client complaining of mild pain but with stable vital signs and no respiratory distress is incorrect. Red tags are for life-threatening injuries, not minor complaints with stable vitals. This client should receive a green tag.

G. Provide comfort measures only to a client who is unresponsive and has no respirations after repositioning, assigning a black tag is correct. Black tags indicate expectant or deceased patients, and care focuses on comfort rather than attempting futile interventions.

H. Treat all clients in the order they arrive regardless of injury severity or survival potential is incorrect. SALT triage prioritizes acuity and survivability, not arrival time. Treating patients in order of arrival could delay care for critically injured patients.

Rationale:

A. “I can change who I designate as my health care proxy at any time” is correct. This reflects an accurate understanding of patient autonomy. A client has the legal right to revoke or change their health care proxy designation at any point while they are competent. This ensures that the person making decisions on the client’s behalf is someone the client trusts and feels is aligned with their values and wishes.

B. “If I become incapacitated, end-of-life choices will be made by my proxy” is correct. The health care proxy is specifically empowered to make medical decisions when the client is unable to do so, which includes decisions regarding life-sustaining treatments or palliative care if the client becomes incapacitated. This statement demonstrates understanding of the proxy’s role in decision-making during periods when the client cannot provide informed consent.

C. “I have to choose a family member as my health proxy” is incorrect and indicates a need for clarification. A health care proxy does not have to be a family member; the client may designate any competent adult whom they trust to make decisions in their best interest. Limiting this choice to family members is a common misconception that can unnecessarily restrict patient autonomy and may result in appointing someone who is not best suited to represent the client’s values or preferences. The emphasis is on trust, competence, and willingness to act responsibly, not familial relationship.

D. “The health care proxy does not go into effect until I am incapable of making decisions” is correct. This statement accurately describes when the proxy assumes authority. The proxy is activated only when the client loses decision-making capacity, ensuring that the client maintains control over their care while they are competent.